Delivery by Caesarean section, rather than vaginal delivery, promotes hepatic steatosis in piglets

Abstract

There has been a marked increase in the number of babies born by elective CS (Caesarean section). Following CS, the lack of normal stimuli that occur at birth alters the thermogeneic response, but any effects on hepatic metabolism have not been identified. In the present study, we compared the effect of delivery on hepatic metabolism in piglets, born either by CS or VD (vaginal delivery) and fed by TPN (total parenteral nutrition), by measuring lipid metabolism and enzyme activity coupled with metabolomic and genomic approaches. Hepatic lipid in the CS piglets at 7 days post-partum was in excess of 5 mg/g of liver consistent with hepatic steatosis, whereas in the VD piglets the amount of lipid was markedly lower (3 mg/g of liver) and below the threshold for a diagnosis of steatosis. Metabolomic analysis indicated that CS resulted in higher hepatic glycerol and lower glycerol phosphate dehydrogenase activity, suggesting that CS causes a decrease in hepatic gluconeogenesis from glycerol. CS also resulted in altered cholesterol handling and gene expression, despite the same dietary intake for 7 days post-partum. Furthermore, the CS piglets had a lower expression of interferon-responsive genes, but a higher expression of markers of immature hepatocytes. In conclusion, the results suggest that VD promotes normal liver maturation and hepatic metabolism, thereby reducing the accumulation of hepatic lipid.

Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature

“…The magnitude of oxytocin and prolactin responses, which play important mediating roles in milk ejection and in establishing mother-infant interaction (148)(149)(150), differs in mothers delivering by CD and vaginally (52). Differences have also been shown in blood concentrations of appetite-regulating hormones in infants born by CD and VD (151)(152)(153). Rat pups that undergo simulated VD by drawing them through a rubber ring in utero before CD show earlier suckling than pups from the same litters delivered by CD without simulated VD (154).…”

Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study

“…Labour is associated with many changes in levels of maternal and placental hormones and inflammatory cytokines, which we and others32 have hypothesised could influence the development of obesity. Piglet offspring delivered by caesarean section had greater hepatic steatosis and altered cholesterol metabolism compared with those delivered vaginally 33. In mice, oral exposure to lipopolysaccharide during vaginal but not caesarean birth triggered activation of gut epithelial cells 34.…”

Newborn Urinary Metabolic Signatures of Prematurity and Other Disorders: A Case Control Study

“…13 The CS group also accommodates a significant increase in the ketone body acetone, which may be indicative of changes in hepatic fatty acids ß-oxidation and gluconeogenesis, consistently with a previous report on CS-born piglets. 48 …”